Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: A multicenter study

Hiroshi Kunugi, Itsuro Ida, Toshimi Owashi, Mahito Kimura, Yumiko Inoue, Shin Nakagawa, Takafumi Yabana, Takako Urushibara, Rie Kanai, Masako Aihara, Naoya Yuuki, Tempei Otsubo, Akihiko Oshima, Koutaro Kudo, Takeshi Inoue, Yuji Kitaichi, Osamu Shirakawa, Koichi Isogawa, Haruo Nagayama, Kunitoshi KamijimaShinichiro Nanko, Shigenobu Kanba, Teruhiko Higuchi, Masahiko Mikuni

Research output: Contribution to journalArticle

163 Citations (Scopus)

Abstract

There is compelling evidence for the involvement of hypothalamic-pituitary- adrenal (HPA) axis abnormalities in depression. Growing evidence has suggested that the combined dexamethasone (DEX)/corticotropin-releasing hormone (CRH) test is highly sensitive to detect HPA axis abnormalities. We organized a multicenter study to assess the DEX/CRH test as a state-dependent marker for major depressive episode in the Japanese population. We conducted the DEX/CRH test in 61 inpatients with major depressive episode (Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV)) and 57 healthy subjects. In all, 35 patients were repeatedly assessed with the DEX/CRH test on admission and before discharge. The possible relationships between clinical variables and the DEX/ CRH test were also examined. Significantly enhanced pituitary- adrenocortical responses to the DEX/CRH test were observed in patients on admission compared with controls. Such abnormalities in patients were significantly reduced after treatment, particularly in those who underwent electroconvulsive therapy (ECT) in addition to pharmacotherapy. Age and female gender were associated with enhanced hormonal responses to the DEX/CRH test. Severity of depression correlated with DEX/CRH test results, although this was explained, at least in part, by a positive correlation between age and severity in our patients. Medication per se was unrelated to DEX/CRH test results. These results suggest that the DEX/CRH test is a sensitive state-dependent marker to monitor HPA axis abnormalities in major depressive episode during treatment. Restoration from HPA axis abnormalities occurred with clinical responses to treatment, particularly in depressed patients who underwent ECT.

Original languageEnglish
Pages (from-to)212-220
Number of pages9
JournalNeuropsychopharmacology
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 2006

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: A multicenter study'. Together they form a unique fingerprint.

  • Cite this

    Kunugi, H., Ida, I., Owashi, T., Kimura, M., Inoue, Y., Nakagawa, S., Yabana, T., Urushibara, T., Kanai, R., Aihara, M., Yuuki, N., Otsubo, T., Oshima, A., Kudo, K., Inoue, T., Kitaichi, Y., Shirakawa, O., Isogawa, K., Nagayama, H., ... Mikuni, M. (2006). Assessment of the dexamethasone/CRH test as a state-dependent marker for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in major depressive episode: A multicenter study. Neuropsychopharmacology, 31(1), 212-220. https://doi.org/10.1038/sj.npp.1300868